TY - JOUR
T1 - Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease
T2 - A Pilot Study
AU - Arrigo, Alessandro
AU - Rania, Laura
AU - Calamuneri, Alessandro
AU - Postorino, Elisa Imelde
AU - Mormina, Enricomaria
AU - Gaeta, Michele
AU - Marino, Silvia
AU - Di Lorenzo, Giuseppe
AU - Quartarone, Angelo
AU - Anastasi, Giuseppe
AU - Puzzolo, Domenico
AU - Aragona, Pasquale
PY - 2018/4/1
Y1 - 2018/4/1
N2 - PURPOSE: To describe corneal innervation and trigeminal alterations in drug-naive patients with Parkinson disease (PD).METHODS: A case series study was conducted by recruiting 3 early drug-naive patients with PD, 2 men and 1 woman (age: 72, 68, and 66, respectively). Ophthalmologic assessment included Ocular Surface Disease Index questionnaire, visual acuity by the logarithm of the minimum angle of resolution score, pupillary light reflexes, extrinsic ocular movements, corneal sensitivity, and slit-lamp examination. Corneal innervation parameter changes were evaluated in vivo using the Confoscan 4 confocal microscope, and they were compared with a control data set. The Heidelberg Retina Tomograph 3 (HRT3) has been used to assess retinal alterations in our patients, if compared with normal range values provided by the HRT3. Moreover, 3T magnetic resonance imaging (MRI) analysis of water diffusion property changes of trigeminal nerves was performed. All data were analyzed and compared with 2 control data sets made by 14 age-matched controls.RESULTS: Patients with PD showed profound alterations of corneal innervation and of trigeminal diffusion MRI parameters, compared with controls. Strong differences (PD vs. controls) were found for deep nerve tortuosity (Kallinikos mean 19.94 vs. 2.13) and the number of beadings (mean 34.2 vs. 15.5). HRT3 retinal evaluation revealed less structural changes compared with the normal range. Diffusion MRI showed profound changes of white matter diffusion properties (PD vs. controls), with fractional anisotropy decrement (mean 0.3029 vs. 0.3329) and mean diffusivity increment (mean 0.00127 vs. 0.00106).CONCLUSIONS: Corneal innervation changes might occur earlier in patients with PD than in retinal ones. Confocal corneal innervation analysis might provide possible early biomarkers for a better PD evaluation and for its earlier diagnosis.
AB - PURPOSE: To describe corneal innervation and trigeminal alterations in drug-naive patients with Parkinson disease (PD).METHODS: A case series study was conducted by recruiting 3 early drug-naive patients with PD, 2 men and 1 woman (age: 72, 68, and 66, respectively). Ophthalmologic assessment included Ocular Surface Disease Index questionnaire, visual acuity by the logarithm of the minimum angle of resolution score, pupillary light reflexes, extrinsic ocular movements, corneal sensitivity, and slit-lamp examination. Corneal innervation parameter changes were evaluated in vivo using the Confoscan 4 confocal microscope, and they were compared with a control data set. The Heidelberg Retina Tomograph 3 (HRT3) has been used to assess retinal alterations in our patients, if compared with normal range values provided by the HRT3. Moreover, 3T magnetic resonance imaging (MRI) analysis of water diffusion property changes of trigeminal nerves was performed. All data were analyzed and compared with 2 control data sets made by 14 age-matched controls.RESULTS: Patients with PD showed profound alterations of corneal innervation and of trigeminal diffusion MRI parameters, compared with controls. Strong differences (PD vs. controls) were found for deep nerve tortuosity (Kallinikos mean 19.94 vs. 2.13) and the number of beadings (mean 34.2 vs. 15.5). HRT3 retinal evaluation revealed less structural changes compared with the normal range. Diffusion MRI showed profound changes of white matter diffusion properties (PD vs. controls), with fractional anisotropy decrement (mean 0.3029 vs. 0.3329) and mean diffusivity increment (mean 0.00127 vs. 0.00106).CONCLUSIONS: Corneal innervation changes might occur earlier in patients with PD than in retinal ones. Confocal corneal innervation analysis might provide possible early biomarkers for a better PD evaluation and for its earlier diagnosis.
KW - Aged
KW - Case-Control Studies
KW - Cornea/innervation
KW - Female
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Microscopy, Confocal
KW - Parkinson Disease/pathology
KW - Pilot Projects
KW - Prospective Studies
KW - Pupil/physiology
KW - Tomography, Optical Coherence
KW - Trigeminal Nerve/pathology
U2 - 10.1097/ICO.0000000000001517
DO - 10.1097/ICO.0000000000001517
M3 - Article
C2 - 29373337
VL - 37
SP - 448
EP - 454
JO - Cornea
JF - Cornea
SN - 0277-3740
IS - 4
ER -